Multidisciplinary care and the effective management of diabetes mellitus: current challenges

Abstract

The present study aimed at characterizing the clinical profile and the multidisciplinary assistance of the diabetic clientele attended in NAMI/UNIFOR, unit that attends the surrounding community. A retrospective study was accomplished by means of the collected data from 101 diabetes mellitus (DM) patients’ medical registers, between August, 2003 and June, 2004. All patients had the diagnosis of type 2 DM 5.7±3.9 years ago, being 88.1% males and 11.9% females, with an average age of 58.4±12.2 years old. 5.9% of them were taking clorpropramide, 84.1% were using glybenclamide, just 15.8% were on metformin and only 7.9% were on insulin therapy, 1% was taking glipizide, 1% was taking glimepiride and 4.9% had never taken medicaments for that purpose. In 61.4% of the medical registers there wasn’t any reference to dietary orientations and, of the others, 20.8% told to follow the recommendations. In 82.2% of the registers there was also no reference to the accomplishment of physical activity. There were only records of fast glycemias (187±75 mg/dl, 192± 80 mg/dl, 192±75 mg/dl, in three different moments). It was verified that 72.3% of the patients presented hypertension and 56.4% showed dislypidemia. Of the hypertensive patients, only 62.4% were treated with drugs, and of those, 45.5% were using ACE inhibitors, captopril being the most frequently used. They presented an average of 148±26 mmHg of systolic blood pressure and 90±13 mmHg of diastolic blood pressure. In none of the cases there was mention to the use of hypolypemic drugs and only 9.9% of those were taking aspirin. These data suggest that the diabetic patients followed-up at NAMI present high prevalence of associated morbid conditions, been, generally, with inadequate metabolic control and with therapeutics that are liable to adaptation and updating. Considering the benefits of the multidisciplinary care in diabetes and the NAMI potentialities, the need for adoption of new strategies in that extent is observed, possibly directed to team integration, having as goal an effective management of diabetes mellitus